The incidence and prevalence of older adult abuse are not clear, primarily because of varying definitions and a lack of national studies.[8]Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health. 2017 Feb;5(2):e147-56.
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30006-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28104184?tool=bestpractice.com
Review data from 28 countries suggest that the pooled prevalence rate for overall older adult abuse in the community setting is 15.7% (95% CI 12.8 to 19.3), equivalent to 1 in 6 older people experiencing some form of abuse in the past year.[2]World Health Organisation. Abuse of older people. 2023 [internet publication].
https://www.who.int/health-topics/abuse-of-older-people#tab=tab_1
[8]Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health. 2017 Feb;5(2):e147-56.
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30006-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28104184?tool=bestpractice.com
The review found that the prevalence estimate was highest for psychological abuse at 11.6% (95% CI 8.1 to 16.3), followed by financial abuse, neglect, physical abuse, and, lastly, sexual abuse at 0.9% (95% CI 0.6 to 1.4).
Data from the US suggest the prevalence of older adult abuse is approximately 10%.[4]Lachs MS, Pillemer KA. Elder Abuse. N Engl J Med. 2015 Nov 12;373(20):1947-56.
http://www.nejm.org/doi/full/10.1056/NEJMra1404688
http://www.ncbi.nlm.nih.gov/pubmed/26559573?tool=bestpractice.com
In the UK, the frequency of older adult abuse has been estimated at 2.6%.[9]Biggs S, Manthorpe J, Tinker A, et al. Mistreatment of older people in the United Kingdom: findings from the first National Prevalence Study. J Elder Abuse Negl. 2009 Jan-Mar;21(1):1-14.
http://www.ncbi.nlm.nih.gov/pubmed/19197619?tool=bestpractice.com
It is expected that the number of older adult abuse cases will increase as people are living longer. The actual prevalence of abuse is underestimated.[1]Centers for Disease Control and Prevention. About abuse of older persons. Nov 2024 [internet publication].
https://www.cdc.gov/elder-abuse/about
Studies have shown that for every reported incident of abuse, nearly 24 cases are not reported.[10]Storey JE. Risk factors for elder abuse and neglect: A review of the literature. Aggression and Violent Behavior. 2020 Jan–Feb; 50; 101339.
https://www.sciencedirect.com/science/article/abs/pii/S1359178918303471?via%3Dihub
It is important to note that the abuse of older adults is not unique to any particular care setting. It is common in the community setting and in the long-term care setting.[11]Lindbloom EJ, Brandt J, Hough LD, et al. Elder mistreatment in the nursing home: a systematic review. J Am Med Direc Assoc. 2007 Nov;8(9):610-6.
http://www.ncbi.nlm.nih.gov/pubmed/17998119?tool=bestpractice.com
Systematic reviews have found a much higher rate of abuse in institutional versus community settings.[8]Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health. 2017 Feb;5(2):e147-56.
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30006-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28104184?tool=bestpractice.com
[12]Yon Y, Ramiro-Gonzalez M, Mikton CR, et al. The prevalence of elder abuse in institutional settings: a systematic review and meta-analysis. Eur J Public Health. 2019 Feb 1;29(1):58-67.
https://www.doi.org/10.1093/eurpub/cky093
http://www.ncbi.nlm.nih.gov/pubmed/29878101?tool=bestpractice.com
While reports vary, the general consensus is that abuse is equally common in older men and women in Western countries, with higher rates for women in Eastern countries.[8]Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health. 2017 Feb;5(2):e147-56.
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30006-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28104184?tool=bestpractice.com
[13]Lachs MS, Williams C, O'Brien S, et al. Risk factors for reported elder abuse and neglect: a nine-year observational cohort study. Gerontologist. 1997 Aug;37(4):469-74.
http://www.ncbi.nlm.nih.gov/pubmed/9279035?tool=bestpractice.com
[14]Paveza GJ, Cohen D, Eisdorfer C, et al. Severe family violence and Alzheimer's disease: prevalence and risk factors. Gerontologist. 1992 Aug;32(4):493-7.
http://www.ncbi.nlm.nih.gov/pubmed/1427252?tool=bestpractice.com
[15]Pillemer K, Finkelhor D. The prevalence of elder abuse: a random sample survey. Gerontologist. 1988 Feb;28(1):51-7.
http://www.ncbi.nlm.nih.gov/pubmed/3342992?tool=bestpractice.com
There is some evidence that abuse in older men is under-recognised.[16]Melchiorre MG, Di Rosa M, Lamura G, et al. Abuse of older men in seven European countries: a multilevel approach in the framework of an ecological model. PLoS One. 2016 Jan 19;11(1):e0146425.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718635
http://www.ncbi.nlm.nih.gov/pubmed/26784897?tool=bestpractice.com
The prevalence of older adult abuse is estimated to have increased by a factor of 10 during the COVID-19 pandemic.[17]World Health Organization. Addressing violence against children, women and older people during the covid-19 pandemic: Key actions. June 2020 [internet publication].
https://www.who.int/publications/i/item/WHO-2019-nCoV-Violence_actions-2020.1